The Centers for Medicare & Medicaid Services (CMS) Informational Bulletin provides general information to states, stakeholders, and others on the Medicaid and CHIP provisions contained in Public Law 119-21, which CMS refers to as the Working Families Tax Cut legislation.

CMS expects to provide additional detailed guidance in the coming months addressing specific provisions and implementation requirements. They also plan to undertake rulemaking as required under the law or as otherwise warranted.

In late November, the Centers for Medicare & Medicaid Services (CMS) issued this final rule that finalizes payment updates for the End-Stage Renal Disease (ESRD) Prospective Payment System starting January 1, 2026. The final rule includes increases to the base payment rate for dialysis services and new payment adjustment for non-labor costs for providers located in Alaska, Hawaii, and the US Territories. Additionally, the final rule includes changes to the ESRD Quality Improvement Program and the early termination of the ESRD Treatment Choices Model.

This final rule from the Centers for Medicare & Medicaid Services (CMS), issued on November 5 finalized payment updates and policy changes to Medicare’s physician fee schedule.

CMS is permanently adopting the definition of direct supervision that allows the physician or supervising practitioner to provide supervision through real-time audio and visual interactive telecommunications (excluding audio-only), creating an optional add-on code for Advanced Primary Care Management (ACPM) services that would provide behavioral health integration or psychiatric Collaborative Care Model (CoCM) services, modifications to the way that CMS will pay for skin substitutes, a negative 2.5% adjustment to certain non-time-based Relative Value Units (RVUs), and a new mandatory alternative payment model, the Ambulatory Specialty Model. The rule becomes effective on January 1, 2026.

Click here for more more information: CMS Final Rule: Medicare Physician Fee Schedule Payments for Calendar Year 2026.

Recent legislation authorized an extension of many of the Medicare telehealth flexibilities including waiving geographic and originating site restrictions through January 30, 2026.

In support of the extensions, the Centers for Medicare & Medicaid Services (CMS) published a related FAQ document for calendar year 2026. To support access to care in rural communities, telehealth policies allow:

• Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) can serve as Medicare distant site providers for non-behavioral/mental telehealth services through January 30, 2026,
• Non-behavioral/mental telehealth services in Medicare can be delivered using audio-only communication platforms through January 30, 2026, and
• FQHCs and RHCs can permanently serve as a Medicare distant site provider for behavioral/mental telehealth services and the in-person visit requirement for mental health services furnished via communication technology to beneficiaries in their homes is not required through January 1, 2026.

Visit Telehealth.HHS.gov for FAQs on telehealth policies for RHCs and FQHCs.

The Centers for Medicare & Medicaid Services (CMS) recently announced a new initiative aimed at lowering prescription drug spending in Medicaid and improving health outcomes by increasing access to critical medications.

Medicaid programs that choose to participate in the GENErating cost Reductions fOr U.S. Medicaid (GENEROUS) Model will be able to purchase drugs included in the pilot at prices aligned with those paid in select other countries.

The model will launch in January 2026 and run for five years. State Medicaid agencies interested in participating in this model will need to submit letters of intent to CMS and then later will have the opportunity to formally apply.

For more information on the GENEROUS Model, visit https://www.cms.gov/priorities/innovation/innovation-models/generous.

The Department of Veterans Affairs National Cemetery Administration (NCA) released a new Outreach Toolkit (#5) to help raise awareness about VA burial and memorial benefits for Veterans living in rural communities. It includes ready-to-use talking points, social media posts, flyers, info sheets, and digital posters that highlight available benefits and how to apply for them. Organizations and partners may use these materials to provide clear and helpful information to Veterans and their families.

Access the toolkit here: New Toolkit for Rural Veterans

The Pennsylvania Department of Human Services (DHS) is launching Human Services Helpers, a Substack that will cover updates on DHS programs, news from the agency, and how organizations and partners can help their communities. (If you’re not familiar with Substack, check out this article.)

As DHS implements changes required by the federal government under HR1, Human Services Helpers will share resources and tips to help Pennsylvanians affected by these changes understand what is happening and what they must do to keep their benefits. News on the federal government shutdown and its impact on programs like SNAP and LIHEAP will also be shared through this platform.

Sign up for updates and be a helper for PA!

The Pennsylvania Senate Institutional Sustainability & Innovation Committee unanimously passed Senate Bill 998.

Senator Maria Collett’s bipartisan legislation with Senator Rosemary Brown tackles Pennsylvania’s nursing workforce shortage by increasing nurse education capacity at accredited nursing schools in the commonwealth.

Read more.